Surgical menopause: what the research says

Do women with premenstrual disorders go through menopause earlier and have worse hot flashes?

Yes. Women with premenstrual disorders went into menopause about 2.67 times earlier and were more likely to have moderate or severe hot flashes (68.3% versus 55.3%).

What are the most effective treatments for premenstrual syndrome and PMDD?

Serotonin reuptake inhibitors and contraceptives with shortened or no hormone-free interval are the most effective treatments. Some women who do not respond may benefit from GnRH agonist treatment.

Which women are most likely to experience hot flashes during menopause?

Up to 80% of women experience hot flashes during menopause, lasting about 10 years on average. Black and Hispanic women are more likely to experience them, while Asian women are less likely.

What are the different types of premenstrual problems and how should they be diagnosed?

There are different types of premenstrual disorders, and doctors should use specific methods to diagnose PMS and distinguish it from other conditions.

Do hysterectomy or hormonal IUDs reduce premenstrual symptoms in women with heavy periods?

Both treatments significantly reduced premenstrual symptoms by 6 months with similar effectiveness. However, the study involved women treated for heavy periods, not those specifically diagnosed with PMS.

Is premenstrual syndrome related to major depression?

Yes. Women with moderate to severe PMS are significantly more likely to have depression (11.3% to 24.6% depending on PMS severity). Women with both conditions are more severely impaired than those with either alone.

What treatments work for premenstrual syndrome?

Many treatments have been studied for PMS, but researchers face a major challenge: there is no standard way to measure symptom severity, making it difficult to know which treatments truly work.

What is PMDD and how is it treated?

PMDD is a severe form of PMS with physical and behavioral symptoms during the second half of the menstrual cycle. Treatment starts with lifestyle changes and over-the-counter medications, and includes antidepressants if needed.

How should doctors diagnose and treat PMS and PMDD?

Doctors can now diagnose these conditions using specific prospective symptom tracking and have several evidence-based treatments. Antidepressants that increase serotonin, especially when taken only during the luteal phase, work best for severe symptoms.

What treatments work best for PMS and PMDD?

Ovulation suppression and SSRIs (selective serotonin reuptake inhibitor antidepressants) are the two most effective treatments. SSRIs work particularly well for PMDD and can be taken only during the luteal phase of the cycle.

What is the difference between PMS and PMDD, and how should they be treated?

PMDD is a severe condition distinct from PMS that can be diagnosed using standardized criteria and daily symptom tracking for at least two menstrual cycles. Treatment options include lifestyle changes, SSRIs, or surgeries that stop ovulation, all proven effective in randomized trials.

Does endometrial resection work as well as hysterectomy for heavy periods?

Endometrial resection was almost as satisfying as hysterectomy, with 84 out of 99 women satisfied versus 89 out of 95 with hysterectomy. However, hysterectomy was better for reducing premenstrual symptoms like painful periods, bloating, and breast tenderness.

Are mental health conditions linked to the reproductive cycle?

Psychiatric disorders like PMS and postpartum depression are linked to the menstrual cycle and pregnancy. But research on PMS is still early and many questions remain.

What treatments work for PMDD and severe premenstrual symptoms?

This review examines evidence for many treatments including antidepressants, hormonal therapy, cognitive behavioral therapy, lifestyle changes, and herbal remedies for PMDD. The review notes that many women with severe symptoms do not meet full PMDD criteria but still benefit from treatment.

What causes irregular periods?

About 14.3% of Korean women aged 19-40 have irregular periods. Stress and depressive mood are the main causes, not medical conditions. Stress is the strongest factor.

What do experts agree is the best way to treat PMS and PMDD?

A group of international experts agreed that treatment should start with careful diagnosis, and that the main options work either by calming brain serotonin activity or by stopping ovulation, with some other approaches worth more study.

Is depression linked to hormonal changes during the menstrual cycle, pregnancy, and menopause?

Yes. Depression tied to hormonal changes appears in the same women across three life stages (premenstrual, after birth, and menopause). Transdermal estrogen patches may be more effective as first-line treatment than antidepressants.

Does stopping ovulation help premenstrual symptoms?

Yes, transdermal estrogen (patch, gel, or implant) can stop the cyclical hormone changes that cause premenstrual symptoms. However, women usually need monthly progestogen and may experience side effects.

Do different types of PMS symptoms respond better to different medicines?

Yes. Different medications work best for different symptoms. SSRIs help irritability and anxiety. Birth control works broadly. Other drugs target specific symptoms. However, current treatments help fewer than 60% of women.

Does migraine risk change during menopause in women with PMS?

Yes. In women with PMS, migraine is highest in late perimenopause at 31% and lowest after menopause at 7%. Hormone levels also affect migraine risk.

Does a protein called IL-6 in the uterus change throughout the menstrual cycle?

Yes. IL-6 levels in the uterus are low in the first half of the cycle and increase 5 to 10 times in the second half, especially around the time for pregnancy implantation and before the period.

Do common diseases get worse before a woman's period?

Yes. A significant number of women with asthma, arthritis, migraine, diabetes, depression, or epilepsy report that their symptoms get worse before their period, though doctors do not yet fully understand why.

How common are menstrual problems in teenage girls and do they relate to early puberty?

Menstrual pain was very common (69.60%), and over half the girls (51.20%) had PMS symptoms. Girls who started menstruating earlier experienced significantly more menstrual pain.

What is premenstrual dysphoric disorder (PMDD) and what treatments work for it?

PMDD is a severe form of premenstrual mood disturbance, separate from milder PMS, and this review reports that SSRIs and treatments that stop ovulation (hormonal or surgical) have been shown effective in placebo-controlled trials.

Do women with a history of PMS have higher risk of osteoporosis?

Women who had PMS symptoms or irregular periods in the past were more likely to develop osteoporosis after menopause. However, because women had to remember their past symptoms years later, the accuracy of these results is uncertain.

How common are period-related symptoms in Italian women, and do they differ from American women?

Period-related symptoms are common in Italian women, occurring most often during the menstrual phase. Italian women reported more symptoms overall than American women, though the difference was smaller for premenstrual symptoms.

Does rollerball endometrial ablation work for very heavy periods?

Yes. Most women had much lighter periods or stopped bleeding entirely, and many experienced less period pain and fewer premenstrual symptoms.

How much of PMS comes from your mind versus your body?

Psychological factors are important. After hysterectomy when women no longer had periods, their premenstrual symptoms dropped significantly, suggesting that psychological factors played a major role before surgery.

Does long-term estradiol implant therapy help PMS symptoms?

Yes, all 50 patients had continued benefit for all symptoms over 5.6 years, with 74 to 96 percent relief depending on the symptom. However, about 58 percent developed progestin side effects, and 8 patients needed hysterectomy.

Does surgery cure PMDD that doesn't respond to medication?

In this one woman with severe treatment-resistant PMDD, removal of the uterus and ovaries led to long-term remission of symptoms, though she had severe depression immediately after surgery. We cannot say whether this would work for other women with PMDD.

What causes PMDD and what treatments are available?

PMDD seems to come from the body's abnormal response to hormone and brain-chemical shifts, shaped by genes, stress, immune function and opioid pathways. Several treatments exist, from SSRIs to surgery in severe cases, but this paper only summarises existing research, not a new trial.

Is the uterine fibroid symptom survey a reliable tool for measuring treatment outcomes?

This study validated a survey designed to measure fibroid treatment success, but the abstract does not report whether the validation was successful.

Can stopping ovulation help severe PMDD when other treatments do not work?

Yes. In this case, a woman with severe PMDD symptoms had improvement when treated with leuprorelin acetate and full resolution after surgery to remove her ovaries. This is a single case of very severe PMDD.

Can we create a rat model of PMDD irritability and does treatment help?

Researchers created rats with PMDD symptoms and found that two drugs reduced a brain receptor linked to the symptoms.

Can researchers create an animal model that shows depression linked to the menstrual cycle?

Researchers created a rat model showing depression-like behavior during the non-receptive phase of the cycle (like the luteal phase in women) and reverse it with fluoxetine, suggesting hormonal changes cause premenstrual depression.

Can ozone therapy reduce PMS symptoms?

In 5 women with PMS, inflammation markers decreased and infections were reduced with ozone therapy combined with diet changes. Women reported improvement.

Does removing the ovaries help severe PMDD with binge eating?

In one woman with severe PMDD and binge eating that hadn't improved with many treatments, removing both ovaries stopped all PMDD symptoms including the binge eating and food cravings. This is one person, so we can't know if it works for others.

How should doctors diagnose and treat PMDD?

This review explains that PMDD needs to be carefully told apart from other mental health conditions, and that antidepressants (SSRIs and SNRIs) are the recommended first treatment, with other options available if those don't work.

What is the experience of living with PMDD and how well do doctors understand it?

Women with PMDD reported severe suffering including suicidal thoughts and felt misunderstood by both doctors and family members.

What is it like to live with PMDD and how do you experience healthcare?

Women with PMDD reported severe suffering including suicidal thoughts and inability to do daily tasks premenstrually. Most felt misunderstood by family and healthcare providers, and many waited a long time for diagnosis.

Does migraine increase during menopause, and can hormone therapy help?

Women who had PMS before menopause are more likely to experience increased migraine during the menopausal transition. Continuous hormone replacement therapy, particularly using skin patches or gels, may help prevent hormone-related migraine attacks.

How are hormones related to depression in women?

Depression in women is caused by hormonal changes at certain times: before periods, after birth, and around menopause. These can be effectively treated with medications or procedures that change hormone levels, especially transdermal estrogens.

What causes premenstrual syndrome and what is the best treatment?

PMS is triggered by progesterone changes after ovulation, though the exact cause is not fully understood. Antidepressants called selective serotonin reuptake inhibitors are the most effective and recommended first-line treatment.

Does hormone therapy help women with depression linked to periods and menopause?

Yes. Thirty-five percent reported being cured and 55 percent had considerable improvement. For 94 percent, hormone therapy was life-changing for the better, and none reported worsening.

Does stopping progesterone cause depression-like behavior?

Yes. Stopping progesterone caused depression-like behavior in rats that was reduced by amitriptyline but not by fluoxetine or duloxetine.

Do women with PMDD have different ovaries or hormones than women without it?

Women with PMDD had significantly fewer developing egg follicles than women without PMDD, but did not have polycystic ovaries or higher male hormones as researchers expected.

What causes PMS and PMDD?

PMS and PMDD are triggered by hormonal changes after ovulation, but not by abnormal hormone levels. The brain's calming system (GABA) and mood system (serotonin) are both affected by progesterone changes.

How can doctors manage premenstrual-like symptoms caused by hormonal treatments containing progestogen?

No clear evidence exists, but doctors should recognize that hormonal treatments like contraception can cause PMS-like symptoms cycling with medication use, termed progestogen-induced premenstrual disorder, and manage based on clinical experience.

How can doctors tell the difference between severe PMS and bipolar disorder?

Doctors can tell the difference by looking for symptoms that clearly follow the menstrual cycle and improve during pregnancy. These patterns occur in severe PMS but not in bipolar disorder, and severe PMS doesn't respond to antidepressants or mood-stabilizing medications used for bipolar disorder.

Should surgery be used to treat PMDD?

Surgery (removing both ovaries and uterus, followed by low-dose estrogen therapy) can be effective for PMDD, but only for women who don't respond to medications or cannot tolerate them.

Do asthma symptoms get worse around menstruation?

In this study of Saudi women with asthma, 8.2% had asthma symptoms that got worse around menstruation. Women with more severe asthma overall were more likely to experience this pattern.

How common are premenstrual symptoms in women around age 40?

About 38% of women around age 40 had three or more premenstrual symptoms, and about 4.7% reported them as severe.

Is vaginal hysterectomy safe when performed as same-day surgery?

Yes, vaginal hysterectomy appears as safe as traditional overnight hospital stay, with 91.5 percent of women discharged within 24 hours and only 6.2 percent needing readmission. However, this research is not about PMS or PMDD.

Can antidepressants reduce anxious-like behavior during low-hormone phases in female rats?

Yes. Fluoxetine, desipramine, nomifensine, diazepam, and progesterone all reduced anxious-like burying behavior during the low-hormone phase. Chlorpromazine had no effect.

Is PMS severity linked to how bad your migraines are?

Yes, PMS and migraine severity are moderately connected. Women with migraines have worse PMS symptoms when their migraines are worse, throughout the menstrual cycle and even when hormones are surgically suppressed.

What factors are associated with having a hysterectomy in women veterans?

Premenstrual syndrome was one of several factors. Women with PMS were 1.6 times more likely to have had a hysterectomy (OR 1.6, 95% CI 1.1-2.3). Other factors included older age, multiple pregnancies, and PCOS.

Is hysterectomy and ovary removal an effective treatment for severe PMS?

Yes, 96% of women were satisfied with the surgery and 93.6% reported complete resolution of PMS symptoms. However, this is major surgery requiring ongoing hormone therapy and should only be considered for women with severe, treatment-resistant PMS.

Does the antidepressant fluoxetine reduce aggressive behavior during low-hormone phases in female rats?

Yes. Fluoxetine at 10 mg/kg given for 4-5 days reduced aggressive behavior both during the naturally low-hormone phase and after hormone replacement in rats without ovaries.

What are women's experiences with getting diagnosed and treated for PMS by doctors?

Most women took many years and saw multiple doctors before being diagnosed. Most doctors didn't use proper diagnostic tools, and only about 1 in 4 provided helpful treatment.

Can hormones trigger PMS symptoms in women without ovaries or a uterus?

Not clearly. Some individual women showed links between progesterone and symptoms, but results overall were not statistically significant. Women don't respond uniformly to hormones.

Does stopping the menstrual cycle help skin conditions that get worse before periods?

Yes. In this one woman, both a hormone medicine and surgery to remove her ovaries showed dramatic improvement in her skin condition.

What is premenstrual syndrome and how is it diagnosed and managed?

Premenstrual syndrome is a real illness with physical, mental, and behavioral symptoms that occur cyclically and need treatment. Diagnosis uses symptom history, exams, and daily ratings to confirm patterns.

Does the uterus cause premenstrual symptoms?

Women who had their uterus removed showed large improvements in premenstrual symptoms. This suggests the uterus may play a role, though the study cannot prove this.

Does the luteal phase of the menstrual cycle increase the risk of seclusion in female psychiatric patients?

No. No clear difference was found in seclusion rates between women in the luteal phase and those in other cycle phases.

How are irritable bowel syndrome and chronic pelvic pain related?

They often occur together and share similar psychological causes like depression and childhood trauma. IBS symptoms get worse during menstruation and worsen pain outcomes after surgery.

Is premenstrual syndrome a significant public health problem?

According to the author, yes. Between 25 and 35 percent of women find PMS worrisome enough to need specialist care, and 5 to 10 percent experience severe symptoms. However, this is an opinion piece rather than a research study.

Does hormone withdrawal change how brain blood vessels respond to serotonin?

In lab tests with rabbit blood vessel tissue, hormone withdrawal made the vessels more sensitive to serotonin. Both sudden and long-term hormone removal had this effect.

Does removing the uterus reduce PMS symptoms?

Yes. Removing the uterus resulted in a 66% reduction in premenstrual symptoms. However, one woman still had mood symptoms after surgery, suggesting the uterus is not the only factor involved.

Does medroxyprogesterone acetate cause side effects when added to hormone therapy?

No, this study found no significant physical or psychological side effects from medroxyprogesterone acetate compared to placebo, regardless of women's PMS history.

Do women who've had a hysterectomy still get premenstrual symptoms?

Yes. Most women who have had a hysterectomy but still have ovaries continue to have cyclic mood and physical symptoms. However, symptoms clustering late in the cycle (like traditional PMS) were less common than in women who still menstruate.

Why do some women need very high hormone levels from implants?

Women needing very high estrogen levels from hormone implants often have a history of depression or surgical menopause. This suggests they may require higher hormone levels to control their symptoms.

Can removing the ovaries cure severe PMS that hasn't responded to other treatments?

In this small study of 14 women, yes: shutting down ovarian hormones with medication gave complete relief, and surgery to remove the ovaries and uterus (plus low-dose estrogen) gave lasting relief afterward.

Does removing the ovaries and uterus cure severe PMS?

Yes. In this group of 14 women with severe, treatment-resistant PMS, all symptoms disappeared after surgery with continuous estrogen replacement. However, this is major surgery appropriate only for women with severe, debilitating symptoms who have failed other treatments.

Can women without a uterus still get PMS?

Yes. Three women without a uterus but with intact ovaries had PMS when tracked daily, showing that PMS is linked to ovarian hormones, not the uterus or psychological factors.

Are LHRH agonist drugs helpful for treating severe PMS?

LHRH agonists appear beneficial for some women with severe premenstrual tension but worsen symptoms in others. They cause serious side effects like bone loss, making them unsuitable as long-term treatment for younger women.

Does removing the uterus stop PMS symptoms?

No. One woman continued experiencing PMS symptoms even after having her uterus removed. Her mood and physical symptoms still worsened in the second half of her ovarian cycle.

What medicines work best for treating moderate to severe premenstrual syndrome?

For mild to moderate PMS, the first approach should be diet, exercise, and nutritional supplements. For severe cases, medications like danazol, estrogen implants, or progesterone at 300 mg per day can be tried, though evidence for some is still limited.

Does the menstrual cycle change how your body's stress hormone system responds?

No. Baseline stress hormone levels and the body's response to a stress hormone injection did not change across different menstrual cycle phases.

What medical treatments are proven effective for PMS?

There is no clear evidence that any single medical treatment is definitively effective for PMS, though psychological approaches may also be worth considering.

What are the best methods for studying premenstrual syndrome?

Good PMS research should use well-defined patient groups, confirm reports with daily monitoring, consider different types of biological changes, exclude placebo responders before testing treatments, and use double-blind placebo-controlled crossover designs.

Do women with PMS show different hormone patterns and ovulation timing after the corpus luteum is removed?

Yes. Women with PMS took longer to ovulate after corpus luteum removal (21 days versus 19 days in controls) and had lower FSH levels, suggesting their hormonal feedback system is more sensitive.

Does stopping hormone production help severe PMS?

Yes. In this 6-month study of 8 women, a GnRH agonist (which stops ovarian hormone production) relieved both physical and behavioral symptoms. Long-term safety is unknown.

Do premenstrual tension symptoms go away after hysterectomy?

No, cyclical mood and physical changes linked to the menstrual cycle continue after hysterectomy in women who had premenstrual tension syndrome, which suggests the cause is hormonal rather than related to the uterus itself.